How does Empire BlueCross BlueShield (NY)'s rate for CPT 96139 compare to Medicare?

The Empire BlueCross BlueShield (NY) local median of $156 is 441% of Medicare's national non-facility rate of $35.40 for CPT 96139.

Reddenda · Rate Intelligence · San Jose-Sunnyvale-Santa Clara, CA

96139 under Empire BlueCross BlueShield (NY), for San Jose-Sunnyvale-Santa Clara, CA providers

Name: Empire BlueCross BlueShield (NY) rates for CPT 96139 among San Jose-Sunnyvale-Santa Clara, CA providers
Creator: Reddenda

Test administration by technician, each additional · Local peer median $156 · Medium confidence

$156 local peer median. Empire BlueCross BlueShield (NY)'s published rate file lists a local peer median of $156 for CPT 96139 (Test administration by technician, each additional) among 37 indexed providers in San Jose-Sunnyvale-Santa Clara, CA. Where a Blue Cross entity’s label carries a state, that state names the file we found the rate in, not the provider’s location. Blue Cross plans file separately per state and do not share rates, even for the same provider. The top of that filed distribution, the P90 target, is $156, which is the same as the median here: this payer's filed rates for this code cluster on one number, so the opportunity in this cell is reaching the median rather than exceeding it. A provider billed below this median is being paid less than peers holding the identical Empire BlueCross BlueShield (NY) contract for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 37 providers · 37 rate records

P10

$88.42

P25

$88.42

Median

$156

P75

$156

P90 (target)

$156

P10$88.42

P25$88.42

Median (P50)$156

P75$156

P90 target$156

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $26.42 – $176.62

The local peer median for CPT 96139 under Empire BlueCross BlueShield (NY) for San Jose-Sunnyvale-Santa Clara, CA providers is $156, drawn from 37 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Empire BlueCross BlueShield (NY) to publish this rate
The bottom of the local market (P10) is $88.42 and the top (P90) is $156; the median-to-P90 spread is $0.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Empire BlueCross BlueShield (NY) to publish this rate
The lowest published rate in this market is $26.42; the highest is $176.62.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Empire BlueCross BlueShield (NY) to publish this rate
This benchmark is drawn from 37 individual rate records that Empire BlueCross BlueShield (NY) itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Empire BlueCross BlueShield (NY) to publish this rate
Medicare's national non-facility rate for CPT 96139 is $35.40, making the Empire BlueCross BlueShield (NY) local median 441% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Empire BlueCross BlueShield (NY) to publish this rate
62.2% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Empire BlueCross BlueShield (NY) to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

37 providers bill this code to this payer in this metro.

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These are the rates Empire BlueCross BlueShield (NY) publishes for CPT 96139 (Test administration by technician, each additional) among San Jose-Sunnyvale-Santa Clara, CA providers. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

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Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Empire BlueCross BlueShield (NY)'s own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Empire BlueCross BlueShield (NY) to publish this rate. Page generated 2026-08-24 05:43 UTC; the live index is queried in real time on every request.